人工心脏瓣膜感染性心内膜炎临床分析

CLINICAL ANALYSIS OF PROSTHETIC VALVE ENDOCARDITIS

目的 探讨人工心脏瓣膜感染性心内膜炎 (PVE)的临床特征 ,提高PVE的诊治水平。方法 通过分析 2 6例PVE的临床表现 ,分析其治疗和预后情况。结果 PVE临床不少见 ,发热是最常见的临床表现 ( 92 .3 % ) ,其次是贫血 ( 88.5% ) ,栓塞 ( 2 6.9% )。血培养和超声心动图是诊断PVE的重要手段 ,阳性率分别为 46.2 %和 73 .1%。早期PVE较晚期PVE预后差、死亡率高 ,分别为 66.7%、3 3 .3 %。主张早期、大剂量、长疗程的抗生素治疗 ,早期手术治疗可改善预后。本组病人总死亡率 3 4 .7% ,死亡原因 :心力衰竭 ( 77.8% )、栓塞 ( 2 2 .2 % )。结论 PVE预后差、死亡率高 ,应早期预防、早期诊断。

Objective\ Try to find out the clinical characteristics of prosthetic valve endocarditis(PVE) for diagnosis and treatment. Methods\ All of the 26 patients were from Guangdong province people′s hospital,collected their data during hospitalization, analyzed their clinical manifestation and process of treatment. Results\ The commonest symptom was fever, next was anemia,the third was embolism. Blood culture and echocardiogram are important methods for diagnosis of PVE. The early use and the heavy dose of antibiotic was very important. The use of antibiotic was a basic method of treatment. Conclusion\ PVE is serious complication of heart valve replacement by artificial. It has poor prognosis and high mortality rate.